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The Surgical outcomes of fundus-first technique in lowering the rate of bile duct injuries and bleeding during open cholecystectomy that facing intraoperative difficulties: A single-center prospective study: The surgical outcomes of open fundus-first cholecystectomy technique.
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Background: The problem of difficult gallbladder is not clearly defined and associated with real missing of therapeutic approaches that decreased morbidity. Moreover, the difficult gallbladder was reported as a contributing risk factor for biliary injury due to raised difficulty in surgical dissection within Calot’s triangle. The aim of this study is to determine the surgical outcomes of the open fundus-first cholecystectomy in lowering the rate of lethal intraoperative risks.

Subjects and Methods: Our prospective study conducted during the period of January 2019 to December 2022 at Ibn Sina specialized hospital, Khartoum, Sudan, for two hundred and fifty-three patients underwent elective open fundus-first cholecystectomy for intraoperative difficulties.

Results: the majority of cases had long-standing cholelithiasis with intraoperative difficulties revealed by pre-operative TUS and MRCP which required open fundus-first cholecystectomy in 173 (68.4%) of patients, (P-value <0.05). The operative surgical time was 120 minutes in 103 patients (40.7%), (P-value <0.05). During open cholecystectomy, variable intraoperative difficulties were found in all patients, (P-value <0.05) and were divided into: (A) Contracted intra-hepatic gallbladder seen in 157 (62.1%) of cases; (B) Distorted anatomy within Calot's triangle seen in 135 (53.4%) of patients; and (C) Intraoperative bleeding from the liver bed was observed as bloody oozing form in 150 (59.3%) of cases. Our patients had minimal postoperative complications like mild wound infection in 8 (3.2%) of cases and mortality rate was zero. 

Conclusions: There is a need for appropriate therapeutic and preventive strategies in healthcare systems for safe dealing with difficult cholecystectomy. Unclear anatomy due to severe inflammatory dense adhesions at Calot’s triangle and CBD stones needing difficult surgeries are the most important limiting factors for fundus-first laparoscopic cholecystectomy. Hence, we humbly recommend an open approach of fundus-first cholecystectomy as safe surgical option to reduce the incidence of bile duct injuries and intra-operative bleeding.

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Publication Date
Mon Jan 01 2018
Journal Name
Al–bahith Al–a'alami
The Communicative Integration in New Media: Building a Communicative Model
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The internet, unlike other traditional means of communication, has a flexibility to stimulate the user and allows him to develop it. Perhaps, the reason for the superiority of the internet over other traditional means of communication is the possibility of change and transmission from one stage to another in a short period. This means that the internet is able to move from the use to the development of the use and then the development of means and innovation as the innovation of the internet is a logical product of the interaction of the user with the network. The internet invests all the proposals and ideas and does not ignore any even if it is simple. This is represented in social networking sites which in fact reflects personal emotio

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Publication Date
Sat Sep 24 2022
Journal Name
Arab World English Journal
Conflict in Atwood’s The Handmaid’s Tale: A Critical Discourse Approach
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Conflict is a common but complicated phenomenon. It has been extensively researched in many domains, including philosophy, sociology, psychology, and linguistics. Using the Critical Discourse Approach, this study examines the issue of self-society conflict in The Handmaid’s Tale. The significance of this work lies in the identification and explanation of the discursive strategies that force the ideological polarization of the positively portrayed self versus the negatively portrayed other. The purpose of this study is to answer two questions: what are the discursive strategies used in The Handmaid’s Tale to create a positive or negative representation, and how are these strategies implemented? Five extracts from The Handmaid’s

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Publication Date
Fri Mar 21 2025
Journal Name
Iklil For Human Studies
Review Article A Feminist Gothic in the American Literary Fiction
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Teresa Fitzpatrick presents a connection between oppressed women and the plant of Wisteria in gothic fiction in her article “Wisteria: A Female Eco-Gothic Metaphor in American Fiction Through the Ages.” The connection between women and nature is common in literature as women are usually compared to the beauty or ferocity of flowers, rivers, or natural phenomena in general. The connection extends to the architecture and sort of plants that appear in gothic literature. Gothic novels have routinely been connected to the secrets and life stories of women who cannot have the liberty to live or share them outside their homes. A fearful house with a prisoned person, ghost, or a secret is mostly normally found in gothic writing. Women have exce

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Publication Date
Mon Sep 03 2018
Journal Name
Al-academy
A new vision for the classic in contemporary fashion designResearch
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        fashion designers who have benefited greatly from the mobilization of ancient aesthetic ideas in the heritage of the people and guaranteed in their productions so that there is no change In the aesthetic value created by the designers of the research in the ancient heritage to find new signs that reflect the connection of man to the present as the aesthetic value of all the man created by the designs of fabrics and fashion through the ages      The problem of research was determined in the absence of a precise understanding of the nature of classical thought in fashion and the absence of a clear perception of the sustainability of this thought in contemporary fashion. He

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Publication Date
Wed Sep 30 2015
Journal Name
College Of Islamic Sciences
Orbital factors in the hair Alberdony: (Denial is a model
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The theory of Pilgrims in the Magra is based on Dekru's view that the mgha is considered a pilgrim, and that the pilgrims are pilgrims
Tujia purely exposes the abstract temptation structure, and that the discharge of the Mfezouz Mfarouz is through factors
This theory tends to highlight the role of pilgrim function as a language
There is no preservation unless directed towards a particular outcome. Gemma can include morphine blindness
Or formulas that allow for the presentation of a pilgrimage to a writer in addition to the content of the news, and the guidance of the recipient
In one direction or another.
 The orbital masses are one of these morphines and functional components that achieve function
The Togolese

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Publication Date
Tue Feb 03 2026
Journal Name
Journal Of The College Of Education
The schools importance at the age of the message and its impact historical thought
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Publication Date
Fri Oct 28 2022
Journal Name
Political Sciences Journal
The political and economic repercussions of the Chinese Marshall Plan on the Arab world
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China is moving towards building the largest economic power in the world, so what does this mean economically and politically for Europe, America, the Middle East and the Arab world? This project is called the expansionist Chinese Marshall Plan which is a revival of the old Silk Road in a new way. It represents the aspirations of the Chinese people and their president, Xi Jinping, to build a transport route from Asia to Europe and a railway plan to transport goods. The purpose of this is to develop the economic growth model, expand into new markets, promote the Chinese currency, and expand economic and political influence in the areas covered by the Chinese initiative. Equal opportunities in distributing investments to these countries, a

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Publication Date
Sun Feb 10 2019
Journal Name
Journal Of The College Of Education For Women
The Foreignized Translation: One Approach to Respect and Preserve the Culture of the other
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Domesticated translation has been for a long time the norm in cultural communication between nations all over the world. The texts are translated mainly into English (being the dominant language) in terms dictated principally by the requirements of the target language (English). The claim has been that fluency, readability, and immediate intelligibility can be guaranteed as far as the reader of the target language is concerned (English). The foreignness of the text (of the culture which produced it) would be not preserved. Not only this. Being the language of predominant cultures, English has become number one among languages into which texts are translated. The imbalance has been noticeable between the volumes of works translated from a

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Publication Date
Tue Aug 15 2023
Journal Name
Al-academy
The Aestheticof Balance And Its Relationship To The Design of The Industrial Product Shape
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The study tagged: (The aesthetics of balance and its relationship to the design of the body of the industrial product) discussed the role of balance in the design of industrial products of different shapes, colors and sizes, as well as their function. Based on the research problem that was determined by the following question: What is the relationship between balance and the design of the body of the industrial product? The aim of the research is to: reveal the statement of the effectiveness of the balance in the design of the industrial product body.
The study was defined in four chapters: in the first chapter, a problem, the importance, and the aim of the research were presented. The second chapter contained the theoretical framewor

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Publication Date
Thu Dec 31 2015
Journal Name
Al-khwarizmi Engineering Journal
Design and Construction of Electrical Magnate to Study its Efficiency and the Optimum Parameters to Produce Alkaline Magnetic Water and Treating the Sea Water to be Suitable for Irrigation
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Abstract

Electrical magnate  was designed and constructed,  the optimum Magnetic flux  and the effect of time on the physical properties of the alkaline (magnetic water) produced from the bottled drinking water [the total dissolved solids (TDS) or the electrical conductivity, and pH] were studied, to simulate ZamZam water in Mekka Saudi Arabia. Also, the efficiency of magnetic field from this designed electrical magnate in decreasing the TDS of sea water (of 1500 ppm NaCl Content), to convert it to water suitable for irrigation (TDS<1000 ppm) was investigated in this work.The results show that the magnetic flux from our designed electrical magnate in the range of (0.013- 0.08) Tesla and 30 minut

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